Negative physiological conditions (e.g., attention deficit, lower back pain, pressure ulcers) may be experienced by people who are seated for long periods of time (e.g., long-haul truck drivers, airline pilots). Pressure ulcers are often experienced by people having compromised mobility (e.g., the elderly and infirm). People inflicted with spinal cord injury (SCI) are particularly prone to developing pressure ulcers. A pressure ulcer is any lesion caused by unrelieved pressure that results in damage of underlying tissue. Pressure ulcers may develop following a prolonged period of compression of the tissue between a bony prominence and a surface.
Unrelieved pressure may result in occlusion of capillaries and lead to ischemia, which has historically been considered a major factor leading to pressure ulcer formation. The cost of treating an individual pressure ulcer ranges up to $40,000 but can exceed $100,000 depending on severity of the wound. Up to 24% of persons residing in nursing homes reportedly have developed a pressure ulcer (also called bed sores). When a person is in a seated position, his or her weight typically rests on a section of the pelvic girdle called the ischial tuberosity (specifically, the inferior, posterior portion of the ischium). There are two of these bony swellings, left and right, sometimes called the sitting bones, which are located on the posterior, inferior portion of the ischium. The gluteus maximus muscle lies over it when a person is standing; however, when he or she sits down, the muscle shifts to a position that exposes the ischium tuberosity, which then bears the majority of the weight, and pressure ulcers may occur.
Pressure ulcers are a frequently occurring healthcare problem throughout the world. Pressure ulcers pose a significant threat to the quality of life for people confined to wheelchairs, such as persons inflicted with spinal cord injury (SCI). Pressure ulcers once formed may lead to sepsis and early death. Pressure ulcers remain the most common secondary condition associated with SCI, and has been reported to occur in from 28% to 85% of patients with SCI, often within a few days of injury. It is estimated that more than half of the SCI population will develop at least one pressure ulcer in their lifetimes. In Europe, treatment of illness associated with pressure ulcers has been estimated to result in up to 4% of total healthcare expenditure. The United States alone spends about $1.4 billion annually on the treatment of pressure ulcers for people with SCI. It has been estimated that the cost of treating pressure ulcers is 2.5 times the cost of preventing them. Considering the numbers and cost of treatment, pressure ulcers are an important public health problem. There is an urgent and growing need to develop effective modes of prevention and treatment.
Although wheelchair tilt and recline functions are typically used for pressure ulcer prevention, present approaches cannot determine at what angles wheelchair tilt and recline provide effective prevention of pressure ulcers. Clinicians typically recommend uniform guidance to all patients. However, clinical evidence clearly shows that the SCI individuals demonstrate a wide variety of requirements. Consequently, universal guidelines cannot satisfy all the needs. Hence, personalized configuration of wheelchair tilt and recline for each individual is more desirable and beneficial.
It is known that traditional statistical methods can be used to model biomedical problems. However, statistical methods are found less capable of finding patterns, dealing with data that may contain noise, or analyzing non-linear and dependent data. Artificial intelligent techniques on machine learning, on the other hand, have played increasingly important role in bioinformatics for classifying and mining data. Such techniques can capture patterns based on examples (i.e., training data) even though the underlying nature, principles, and/or probability distributions may not be clear. It is, therefore, an object of the present invention to use an artificial intelligent (AI) module (artificial neural network in the current implementation) to provide a method and apparatus with which to discover patterns driven by individual human conditions, operational environments, and outcome or use objectives. It is a further objective of the present invention to provide personalized guidance and configuration control for seating support, adjustment, and positioning including wheelchair tilt and recline usage for people confined to wheelchairs and who may be inflicted with SCI.
Tilt and recline (TR) functions are two of the most desirable features on a wheelchair for relieving seating pressure. Tilt refers to a change of the seat angle orientation while maintaining the seat-to-back angle and recline refers to a change of the seat-to-back angle. Despite the importance of TR functions, the majority of the wheelchairs do not offer a built-in mechanism to measure TR angles. Wheelchair users tend to adjust TR angles based on their own preferences and perceptions. However, research shows that wheelchair users rarely adjust enough tilt or recline angles to relieve seating pressure, which has been recognized as a major causative factor of pressure ulcers (PUs). The reasons for the ineffective usage of wheelchair TR functions are in part due to the lack of a convenient way to measure wheelchair TR angles, and in part due to the lack of a practical way to monitor whether wheelchair users follow the clinical guidelines of wheelchair TR usage.
In addition, for work-related injuries alone, knee and shoulder injuries were among the most common nonfatal single injury types. Further, injury to the knee, shoulder, and ankle are common among athletes. Shoulder and knee injuries were identified as the most expensive injury types in terms of total costs (average cost per claim×number of claims). Traditionally, self-report is a major approach for evaluating the rehabilitation progress. However, self-report may be very subjective and could lead to serious results. For example, many people with knee injuries will not be able to recover to the level of pre-injury. Hence, an effective and convenient recovery approach is very desirable to improve recovery quality and reduce the cost.